New Jersey Medicaid Statistics

Enrollment

  • From 2006 to 2007, 22% of low-income women were enrolled in New Jersey Medicaid.
  • In July 2011, a million New Jersey residents were enrolled in Medicaid.

Costs Covered

  • Total Medicaid spending for New Jersey in 2012 was $10 billion.
  • 44% of Medicaid spending for New Jersey in 2011 went toward individuals with disabilities.
  • 24% of Medicaid spending for New Jersey in 2011 went toward elderly individuals.
  • 8% of Medicaid spending for New Jersey in 2011 went toward adult individuals (non-disabled, non-elderly).

CHIP

  • In September 2012, 27% of children in New Jersey were enrolled in Medicaid.

Medicaid Expansion

  • An estimated 285,000 New Jersey residents have access to Medicaid with the expansion.
  1. What is Medicaid?

Medicaid is a joint federal and state funded program that provides healthcare coverage to millions of low-income Americans and other qualified individuals. In order to enroll, you must meet a set of eligibility requirements that range from financial stability to medical necessity. Medicaid currently covers more than 68 million people for healthcare services. Although the types of plans vary from state to state, the program follows a list of basic medical assistance and health services to all enrollees.

The Children’s Health Insurance Program (CHIP) is also part of Medicaid, offering medical coverage to eligible children under the age of 19. Some of the services CHIP covers include routine checkups, doctor’s office visits, prescription medication, dental care visits, vision examinations and more. A parent or caretaker of a dependent child or children can also apply on their behalf.

Since 2014, Medicaid has expanded healthcare coverage to 28 states across the nation, thanks to the Affordable Care Act. With this type of expansion, thousands of individuals in the cooperating states now have access to the program and its wide scope of benefits. Although the federal government is currently covering all related costs of the expansion, states will be responsible for a portion of it in the coming years.

  • How do I apply for Medicaid in New Jersey?

If you would like to apply for New Jersey Medicaid, you can obtain more information about your eligibility requirements by calling the New Jersey Department of Human Services Medicaid phone number at 1-800-356-1561. You can also use this number if you have questions about how to apply for Medicaid. A Medicaid customer service agent will be able to assist you with any queries or doubts you may have, as well as guide you through the application process.

You can also call one of your local county welfare agencies, or make an office visit to fill out your application in person. There are several country welfare offices all across the state, including but not limited to the following locations: Camden, Cape May, Atlantic, Bergen, Burlington, Salem, Somerset, Union, Warren, Middlesex, Passaic, Ocean, Monmouth and others.

Visit the New Jersey Department of Human Services website to find out contact information, such as each office’s physical address, fax number and phone number. Additionally, you can review hours of operation to determine the best time to call or drop in for a visit. Keep in mind, though, that these hours may vary and change without notice.

In order to reach NJ Medicaid by mail, simply send your written letter or request to the address below:

NJ Department of Human Services
Division of Medical Assistance and Health Services
PO Box 712
Trenton, NJ 08626-0712

  • What does New Jersey Medicaid cover?

Several Medicaid healthcare benefits are mandatory, and therefore provided to all eligible individuals regardless of the state. Some of the medical services offered to all Medicaid enrollees include inpatient hospital treatment, outpatient hospital treatment, nurse midwife services, physician services, family planning assistance, home health care, laboratory testing, X-ray services, nursing facilities for adults, transportation to medical facilities, qualified health center services, nursing facility services, free-standing birth center services and Early and Periodic Screening, Diagnostic and Treatment Services (EPSDT).

Depending on the type of plan you are enrolled in, Medicaid in NJ also offers these specific kinds of services: personal care, private duty nursing, hearing aid services, medical supplies and equipment, optometry services, chiropractic services, optical appliances, physical therapy, occupational therapy and speech therapy

  • Who is eligible for Medicaid in New Jersey?

To be considered eligible for New Jersey Medicaid, a potential enrollee must have low or very low income. There are other factors and categories that make a family or individual eligible for Medicaid:

  • You are a parent of a dependent child or children.
  • You are the caretaker of a dependent child or children.
  • You are a pregnant woman.
  • You are a senior over the age of 65.
  • You are a blind individual

You must also be a resident of New Jersey, and either a United States citizen or a legal immigrant. Keep in mind that prior to beginning the application process, you should gather all essential documents with you. This is because, when determining whether or not you meet eligibility standards, a NJ Medicaid representative will need to review the following: proof of income, proof of pregnancy (if applicable), proof of expenses, proof of citizenship, proof of immigration status, proof of current assets, proof of residency in New Jersey, proof of identity and proof of age. 

If you aren’t sure whether or not you would qualify, call the New Jersey Department of Human Services at 1-800-356-1561 and speak to a Medicaid representative for further assistance.

Review the 2015 New Jersey Medicaid income requirements below:

  • 1 person = $11,770
  • 2 family members = $15,930
  • 3 family members = $20,090
  • 4 family members = $24,250
  • 5 family members = $28,410
  • 6 family members = $32,570
  • 7 family members = $36,730
  • 8 family members = $40,890
  • Add $4,160 for each additional person for families with more than eight family members.
  • What is the Medicaid expansion? Did my state accept the Medicaid expansion?

Thanks to the Affordable Care Act, 28 states across the nation have expanded their Medicaid coverage. Medicaid expansion has allowed millions of previously uninsured individuals to now gain access to the program and meet eligibility standards. New Jersey is one of the states to elect Medicaid expansion, thus providing an estimated 285,000 residents with a better likelihood to enroll and take advantage of a multitude of benefits.

Other states that have currently expanded Medicaid include the following:  North Dakota, Delaware, Pennsylvania, West Virginia, New York, North Dakota, California, Minnesota, Ohio, New Mexico, Vermont, Arkansas, Arizona, Oregon, Maryland, Massachusetts, Iowa, Oregon, Rhode Island, Hawaii, Colorado, Connecticut, Michigan, Washington and Nevada, in addition to the District of Columbia. Wyoming, Utah, Tennessee and Indiana are considering Medicaid expansion but have yet to make a decision.

All Medicaid expansion costs have been covered by the federal government since 2014. This pattern is expected to continue for a couple more years. However, by 2020, each state will be responsible for covering 10 percent of the costs.

  • How do I contact New Jersey Medicaid?

When contacting the New Jersey Department of Human Services for Medicaid-related matters, you can speak to a representative either online, in person or by mail. You can also submit your queries via fax. If you need to request information over the phone, simply call the toll-free Medicaid phone number at 1-800-356-1561. By visiting the New Jersey Department of Human Services website, you can browse through various county welfare agencies. Once you have located the Medicaid office nearest you, you can gather contact information such as their physical address, hours of operation, fax number and phone number.

Keep in mind that available hours may vary from office to office. Some offices, such as the one in Camden County, may be open until 7:30 p.m. on certain days, whereas others close at 5 p.m. It is highly recommended that you call the Medicaid office of your choice ahead of time to verify which time they close to the public.

Whether you would like to update your contact information, or inquire about the benefits of your current NJ Medicaid plan, you can also reach the New Jersey Department of Human Services by mail. Simply write to the address listed below:

Quakerbridge Plaza, Building 7
PO Box 712
Trenton, NJ 08625-0712

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